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PostPosted: Sat Aug 04, 2012 11:43 pm 
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Hey guys it's me TJ. Had to create another account as I lost the password and it was linked to an old email.

I just wanted to bring up something I read in Dr. J's latest blog post:

Quote:
There were several studies a few years ago that showed relapse rates of 100% in people treated with Suboxone for less than a year; those findings, it seems to me, put a damper on the idea that buprenorphine could be useful for short-term detox.


(From his talkzone article "Short Timers")

Dr. J did not cite the studies he was referring to, which is why I've brought it up here. I'm quite surprised because it's not the best academic practice to refer to studies like that without providing citations.

Most people who know me on here are aware that I keep serious tabs on research into relapse rates following treatment options. I cannot recall (by memory) one study that showed complete universal relapse of all participants. One study used an expression like "near universal relapse" while discussing its results, but further research into the actual figures showed approx 8% of participants actually remained clean.

The most interesting thing is that whenever Dr. J's referred to these studies in the past, not once did he say they showed 100% relapse rates. He'd only go as far as saying "virtually 100%", "approaches 100%" or a "very high rate of relapse". How is it then that all of the sudden these same studies can show 100% universal relapse rates?

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Likewise, treatment with Suboxone, in my opinion, should be considered a long-term process. People treated for less than a year have a very high rate of relapse.


Quote:
But the obvious comparisons aside, the simple fact is that short-term use of Suboxone has clearly been shown to be a waste of time—the relapse rate is virtually 100%!


Quote:
If someone asks ‘how long should I stay on Suboxone?’, I’ll reply that several studies show high relapse rates in people who stay on Suboxone for less than 6 months (fact), that more and more physicians are keeping patients on the medication long-term (medical practice), and that in my opinion, many people are best off staying on the medication for an extended period of time.


Quote:
I don’t understand the attitude, and I know from my observations that the attitude is dangerous for opioid addicts, since the relapse rate in people who stop buprenorphine approaches 100% over the long term.


We all know Dr. J's opinions on the issue of short term vs long term buprenorphine, maintenance vs abstinence etc, and that he's heavily in the pro Suboxone camp, which is why I think it's fair to question this statement. He's suggesting that there are at least two (ie several) studies showing 100% relapse rates, without providing citation. I've questioned his misleading representations of these results in the past. Using an expression like "approaches 100%" doesn't sound hopeful at all, but the reality is even the most successful medical treatment of a progressive illness has negative results approaching 100%, as people can only be recorded relapsing or dropping out, not returning.

It'd be nice if someone could help me find these studies, or Dr. J could clarify this himself.

Thanks.


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PostPosted: Sun Aug 05, 2012 7:19 pm 
Dr junig is a heavy fentanyl and other synthetic opiate user for decades. Of coursE he is one sided on suboxone . That doesnt mean people taking. 2 vicodin a day should be on bupe for a lifetime or even for a year . I'm sorry but bup is Tougher than other pills to kick. Let's call a spade a spade


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PostPosted: Sun Aug 05, 2012 7:26 pm 
My uncle used suboxone for short term. And has stayed free from all drugs. One hundred fucking percent? No...


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PostPosted: Sun Aug 05, 2012 9:20 pm 
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Winningduhepic wrote:
Dr junig is a heavy fentanyl and other synthetic opiate user for decades. Of coursE he is one sided on suboxone . That doesnt mean people taking. 2 vicodin a day should be on bupe for a lifetime or even for a year . I'm sorry but bup is Tougher than other pills to kick. Let's call a spade a spade


Dr. Junig IS not a heavy user. He was addicted for SIX months many years ago. Read his story. You just re-wrote his history and presented it as fact. How would you like it if someone twisted your story to make it sound worse? I doubt if you'd like it.

Next, I've been around here for 3.5 years and the majority of people have said that even cold turkey sub withdrawal isn't nearly as bad as full agonist withdrawals, they just last a bit longer, but said to be not as acute. You may be mistakenly applying YOUR experience to that of all others. A common mistake. But it sounds like you're presenting another fallacy as fact. You really need to stop doing that. This isn't the place for it.

Please don't repeat this kind of post. Consider this a warning.

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PostPosted: Sun Aug 05, 2012 11:51 pm 
He said it. Watch his vids


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PostPosted: Sun Aug 05, 2012 11:57 pm 
And I do know what it would be like hat. U kno hoW many people re wrote my story to benefit their own point.


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PostPosted: Mon Aug 06, 2012 12:07 am 
Not sure what I did besides share info from the drs vids ands speak my mind. But if u feel it nessisary to kick me off the forum, go for it


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PostPosted: Mon Aug 06, 2012 1:22 am 
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TeeJay wrote:
Hey guys it's me TJ. Had to create another account as I lost the password and it was linked to an old email.

I just wanted to bring up something I read in Dr. J's latest blog post:

Quote:
There were several studies a few years ago that showed relapse rates of 100% in people treated with Suboxone for less than a year; those findings, it seems to me, put a damper on the idea that buprenorphine could be useful for short-term detox.


(From his talkzone article "Short Timers")

Dr. J did not cite the studies he was referring to, which is why I've brought it up here. I'm quite surprised because it's not the best academic practice to refer to studies like that without providing citations.

Most people who know me on here are aware that I keep serious tabs on research into relapse rates following treatment options. I cannot recall (by memory) one study that showed complete universal relapse of all participants. One study used an expression like "near universal relapse" while discussing its results, but further research into the actual figures showed approx 8% of participants actually remained clean.

The most interesting thing is that whenever Dr. J's referred to these studies in the past, not once did he say they showed 100% relapse rates. He'd only go as far as saying "virtually 100%", "approaches 100%" or a "very high rate of relapse". How is it then that all of the sudden these same studies can show 100% universal relapse rates?

Quote:
Likewise, treatment with Suboxone, in my opinion, should be considered a long-term process. People treated for less than a year have a very high rate of relapse.


Quote:
But the obvious comparisons aside, the simple fact is that short-term use of Suboxone has clearly been shown to be a waste of time—the relapse rate is virtually 100%!


Quote:
If someone asks ‘how long should I stay on Suboxone?’, I’ll reply that several studies show high relapse rates in people who stay on Suboxone for less than 6 months (fact), that more and more physicians are keeping patients on the medication long-term (medical practice), and that in my opinion, many people are best off staying on the medication for an extended period of time.


Quote:
I don’t understand the attitude, and I know from my observations that the attitude is dangerous for opioid addicts, since the relapse rate in people who stop buprenorphine approaches 100% over the long term.


We all know Dr. J's opinions on the issue of short term vs long term buprenorphine, maintenance vs abstinence etc, and that he's heavily in the pro Suboxone camp, which is why I think it's fair to question this statement. He's suggesting that there are at least two (ie several) studies showing 100% relapse rates, without providing citation. I've questioned his misleading representations of these results in the past. Using an expression like "approaches 100%" doesn't sound hopeful at all, but the reality is even the most successful medical treatment of a progressive illness has negative results approaching 100%, as people can only be recorded relapsing or dropping out, not returning.

It'd be nice if someone could help me find these studies, or Dr. J could clarify this himself.

Thanks.


You made your point quite early in your post but you went on and on and on, seeming to do nothing but beat a dead horse. I don't know what your point was in going as far as you did, other that try to make him look bad. Don't you think it's possible that perhaps after all the time he used those words (virtually, approaching, etc) that maybe this time it just was an oversight? Did you try to email him to question him first? Or are you just making an assumption, poking at his reputation, putting him in a position where people can make up things about his history that are simply not true? If you don't like what he and his sites stand for, where's your forum?

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PostPosted: Mon Aug 06, 2012 5:52 am 
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I have no issue with what Dr. J stands for or his opinions. I have a lot of respect for the guy and how much he helps people And I think it's fair to question the things he says on his forum.

Quote:
Or are you just making an assumption, poking at his reputation, putting him in a position where people can make up things about his history that are simply not true?


Can you tell me where I made any suggestion about Dr. J's personal history? If you're trying to somehow pin Winningduhepic's assumption about him on something I wrote in my post, you'll have a hard time.

I chose to post on the forum rather than question Dr. J directly because I wanted to see whether questioning or challenging the thing's Dr. J says is tolerated here, or whether it's discouraged or censored.

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where's your forum?


Good idea!


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PostPosted: Mon Aug 06, 2012 7:26 am 
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TeeJay wrote:
I have no issue with what Dr. J stands for or his opinions. I have a lot of respect for the guy and how much he helps people And I think it's fair to question the things he says on his forum..

I chose to post on the forum rather than question Dr. J directly because I wanted to see whether questioning or challenging the thing's Dr. J says is tolerated here, or whether it's discouraged or censored.


These two statements kind of contradict each other. I in no way shape or form want to argue with anyone. But I just don't understand why go about it this way instead of simply asking what the forum's stance is on "questioning or challenging" the things that Dr. J says. Or better yet, why not just go straight to him and ask him since you respect him on that level. And while you're at it, maybe you could ask him about the 100% remark. I'm sure it was just an oversight.

Again, I am not attcking, challenging, or trying to argue with you. Please don't take it that way....I'm just confused abou tthe route you chose to take to get an answer from him. Because honestly he is the only one that could give you a solid answer. Anyone else would just be speculating.

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PostPosted: Mon Aug 06, 2012 10:32 am 
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Okay let's do this.

Moderators (hatmaker) ... is it okay to question and challenge the things Dr. J says on this forum?


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PostPosted: Mon Aug 06, 2012 11:02 am 
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I don't understand what TeeJay did that was wrong.. I have nothing but the utmost respect for Dr J and I agree with TeeJay on this.. Claims of 100% of ANYTHING need to be backed up with multiple sources in order to have any credibility.. I think this is totally appropriate to discuss because the claim is out there on the internet.. If we just brush by it as a typo or a slip up it may not get corrected- or verified, either is perfectly acceptable- and then someone accepts it as truth.. All TeeJay did was present dialogue (and presented it respectfully , imo).. Respectful dialogue is always good- IMHO..

Now, the next poster drew some inappropriate conclusions but that was separate from anything in the original post but that happens on the internet all the time and it was dealt with accordingly.. I don't understand the issue with the original post.. I'm sorry, but anyone should cite sources on a claim like that.. It's just the proper thing to do..


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PostPosted: Mon Aug 06, 2012 1:19 pm 
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The point isn't that you (or anyone else) can't "challenge" someone, including Dr. Junig. The point is number 1, as I said, you beat a dead horse by repeating your allegation time and time again, for what purposes, I don't know. You could have asked your question in a 1/4 of the words you used, if not much, much less. I don't know, maybe you like to "hear" yourself "talk".

Secondly, you immediately went to a place where you assumed the worst in him rather than the best and just asking him if he left one lousy word out, when ALL of his other posts include that one word (or similar such words). This is how one treats other people like shit. Is this how you treat the people in your life? You assume the worst in them first and only then, if they can prove it to you you'll then agree that they might have meant the right thing? Nice positive way to live.

Thirdly, you now admit that you're just doing this to see if we "would tolerate it"???? Isn't that just another way of saying you're trying to see what you can get away with or what kind of shit you can stir up here?

What makes you think that's acceptable?

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PostPosted: Mon Aug 06, 2012 3:20 pm 
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Here's a Dr Junig quote from an article on The Fix that refers to the 100% relapse rate:

Quote:
When patients take buprenorphine, he says, they quit stealing and lying, they become employable. “Especially if they’re over 40, they do well,” he says. “It’s like they’re taking their blood-pressure pill.” Is his solution to put addicts on bupe forever? “Not necessarily forever,” he says. “Every person I see, going off Suboxone is part of the discussion.” But he says that when a client wants to taper off, he tells them frankly that the odds are against them because studies show 100% of opiate addicts relapse after detox.

Asked for citations for these 100% studies, he says, “I don’t have them at my fingertips. Actually, it’s based on a lot of personal experience. I don’t know if people at treatment centers would even argue this point. They would tell you that with people addicted to opiates in particular, they tend to go through treatment over and over and over."


I'm not sure how much this clarifies the issue, but he does seem to be saying his statement is based on personal experience.

The full article is here - http://suboxforum.com/viewtopic.php?t=7029

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PostPosted: Mon Aug 06, 2012 3:54 pm 
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nogroovin wrote:
I don't understand what TeeJay did that was wrong.. I have nothing but the utmost respect for Dr J and I agree with TeeJay on this.. Claims of 100% of ANYTHING need to be backed up with multiple sources in order to have any credibility.. I think this is totally appropriate to discuss because the claim is out there on the internet.. If we just brush by it as a typo or a slip up it may not get corrected- or verified, either is perfectly acceptable- and then someone accepts it as truth.. All TeeJay did was present dialogue (and presented it respectfully , imo).. Respectful dialogue is always good- IMHO..

Now, the next poster drew some inappropriate conclusions but that was separate from anything in the original post but that happens on the internet all the time and it was dealt with accordingly.. I don't understand the issue with the original post.. I'm sorry, but anyone should cite sources on a claim like that.. It's just the proper thing to do..


I agree with you that claims of 100% of anything need to be backed up. I also agree that it is totally appropriate to discuss. What I don't agree with is how many examples he felt the need to give.... He could have said what he said, without making it look like Dr. J is an asshole. That is my opinion. I am not angry or anything like that, I was just surprised by it, that's all. I would have just asked flat out, if he MEANT to say 100%, because that is a pretty bold statement after all. I probably would have asked for some links to support it too, if he did mean 100%. I just wouldn't have felt the need to point out all of those times he DIDN'T use the phrasing 100% definitively. It isn't a big deal, like I said in my first response, I was just confused and didn't understand why he did it that way. But TeeJay cleared that up. He said he did it because "I wanted to see whether questioning or challenging the thing's Dr. J says is tolerated here, or whether it's discouraged or censored' So, basically I still don't understand why.

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PostPosted: Mon Aug 06, 2012 4:36 pm 
I have a respect for Dr. Junig. It was wonderful of him to make a forum for all of us. It's nice to know your not alone. Also, he is a Dr. that truly knows what addiction is like. I was not coming down on him. I think some people got sensative and I'm still unsure why.

Hatmaker- No, Dr. J was not addicted for "only SIX months" as you said. Like i said it was almost 2 decades. Watch his video- http://www.youtube.com/watch?v=RASNQrfa3ig . I provided a link for you to research before comin at people. I've watched all of Dr. Junig's videos and read many of his articles. He said his fentanyl withdrawal was horrible. I understood him, so I enjoyed watching his videos. It takes a brave man to share all this with the world. Props to him.

"Once an addict , always an addict" Dr. J. - This is why I said he IS an addict of opiates. Just like we all are. I am a 5 year opiate/opioid addict even though I've been totally clean for 3 months.

Okay, now that I've cleared that up for you Hatmaker and for anyone else who thinks my post was "unacceptable". Is it okay if I question or comment a statement from the Dr. himself? Well thanks, I will.

" But he says that when a client wants to taper off, he tells them frankly that the odds are against them because studies show 100% of opiate addicts relapse after detox." - Dr. Junig . Odds are never against someone who really wants something. I just think a little positivity towards someone who wants to kick this is a must, especially from a Dr. No disrespect, just my opinion.

Also, Dr. J says, "They would tell you that with people addicted to opiates in particular, they tend to go through treatment over and over and over." Right, but isn't that part of recovery? I wouldn't use this as a krutch to keep people, in certain circumstances, on long term suboxone.

Everyone is differant. Clearly. Suboxone has saved some lives and others think it is not benefiting them anymore. In my situation it was not making a positive outcome. This forum isn't going to have every single person in love with suboxone, Hatmaker. Just keep that in mind before getting sensative to every post of mine. I don't have anything against you. I like your posts. I come on this forum because it is helping me stay clean off my DOC, suboxone.


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PostPosted: Mon Aug 06, 2012 5:12 pm 
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Hey winngd,

Where in that video does dr j evn talk about his own addiction?


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 Post subject: Glen Bee
PostPosted: Mon Aug 06, 2012 5:40 pm 
Hey there GlenBee,

At 1:13 in the video of the link i posted. He just briefly explains why he is byass on suboxone. and states he was an opiate addict for 16 years.


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PostPosted: Tue Aug 07, 2012 12:29 am 
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Thanks to those who tried to keep things accurate.

I often say 'I've been an opioid addict for 20 years. That is true. My period of active use was much shorter -- mostly codeine for 6 months in 1993, and mostly fentanyl for about 6 months, from 11/2000 until treatment in June of 2001.

To suggest I cite comments on my blog is silly. The source of the 100 % comment was the NIH Summit on Buprenorphine in DC a couple years ago; I cannot tell you the author, but it was one of the talks that had a strong effect on me-- on my ideas about Suboxone, and about my approach to treatment. People often say 'well my uncle didn't relapse...'. To which I say 'great!'. But I add that life is long.... And I had 7 years of wonderful sobriety before the relapse that almost killed me. In fact, seems relapse occurred right about the same time I was boasting about how long I'd been clean!

I don't wish relapse on anyone-- but I think that boasting about anyone else's sobriety is a fool's errand. Anyone who works in the field-- with or without prescribing buprenorphine-- knows that relapse is, unfortunately, a very common feature of opioid dependence. 100%? No. But 'most people'? Yes, absolutely. People looking for citations should search the academic literature; the whole reason for a 'blog' is to be able to share thoughts and experiences more quickly than allowed through the typical literature study.

Thanks all,

J


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PostPosted: Tue Aug 07, 2012 12:44 am 
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Oops-- one more thing... There are TWO areas where I discuss relapse rates. One is 'after short-term buprenorphine i.e. < 1 year. That was from a study presented at the summit referred to above. The second is in reference to release rates after residential treatment; those comments are based primarily on what I've seen, over the years since my 2001 relapse-- at and after that residential treatment, in a doctors' recovery group, in AODA groups over a 6-yr span, while treating prison inmates for almost 3 years, at the VA domiciliary treatment in Milwaukee, from talking to 600+ addiction patients over 6 years in my private practice, and from experiences as med director of a 50-bed residential program over several years.

My point in spelling them out is to say that I'm doing my best to describe what Ive seen with addiction treatment, across a wide range of patients and programs. Of course, YOUR experience may be different--- but I'd be surprised if it was VERY different.


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